Knee Pain: How Chiropratic with Chirostrength Twin Cities Can Help

Your first step in managing knee pain is to decide if you need to see a healthcare provider. We discuss how to make this choice in our blog titled Knee Pain: What Do? I suggest you read Knee pain: what do? before reading this blog

So, you have decided you cannot manage your knee pain on your own and you make an appointment with a healthcare provider (a PT, DC, or MD). What should you expect? The first thing your doctor should do is try to figure out what is causing your knee pain (i.e. a diagnosis). In order to do this, they should have you fill out a detailed history of your current injury and a comprehensive history of your general health. Following this, they should perform a physical exam that includes, range of motion, muscle strength, ligament integrity, reflexes, and sensation. If more information is needed, your doctor may order additional tests such as an x-ray, MRI, ultrasound, and/or blood tests.

Why is it so important for a thorough history and exam to be done? Most knee pain is caused by minor conditions like strains, sprains, bursitis, tendonitis, joint irritation, or general deconditioning of the knee (11). However, knee pain can be caused by serious conditions such as a blood clot, infection, rheumatoid arthritis, and fracture (11,12). A chiropractor, PT, and most primary care MD’s cannot and should not treat people with these conditions; a referral to a specialist is required. So, if you are planning to see a healthcare provider who does not require you to fill out a history or have an exam, find a different doctor.

If you choose to make an appointment with Chirostrength Twin Cities we will start with a detailed history and exam. If we determine that you have a condition that we cannot treat, we will refer you to one of our many trusted referral partners. But this is not the norm. Most knee pain responds well to conservative management; so, we will likely be able to help you (1,7,8,9,10).

How we approach knee pain

Phase 1: Relieve

• Main goal: reduce your pain

• Treatments: we use chiropractic adjustments and soft tissue such as IASTM (or brand of graston) and MRT (our brand of ART), and vibration therapy to alleviate your knee pain. We also partner with practitioners who can perform acupuncture, electrical therapy, and medical injections if needed (8,10).

Phase 2: Restore

• Main goal: Get your knee’s strength and function back to where it was before your injury (1,2,3,13).

• Treatments: simple strength and flexibility exercises will be used to help your knee become more resilient. These exercises will directly focus on the knee, but they will also address the hip, ankle, foot, and any other areas that are contributing to your pain.

Phase 3: Revitalize

• Main goals: Make you stronger and more resilient than you were before your injury. If you are stronger, you are less likely to re-injure your knee (4,5,6).

• Treatments: more complex strength and mobility/flexibility exercises will be used to make your entire body stronger and more resilient. We tailor our exercise plans to your physical limitations, goals, and preferences. We want you to leave our clinic stronger and healthier than before you got injured!

If you want to see how chiropractic can help with pain and injury, book an appointment with Chirostrength Twin Cities at 612-314-0268.

https://chirostrengthtc.janeapp.com/#staff_member/1

1. Swart, N. M., van Oudenaarde, K., Reijnierse, M., Nelissen, R. G., Verhaar, J. A., Bierma-Zeinstra, S. M., & Luijsterburg, P. A. (2016). Effectiveness of exercise therapy for meniscal lesions in adults: A systematic review and meta-analysis. Journal of science and medicine in sport, 19(12), 990–998. https://doi.org/10.1016/j.jsams.2016.04.003

2. Cavanaugh, J. T., & Powers, M. (2017). ACL Rehabilitation Progression: Where Are We Now?. Current reviews in musculoskeletal medicine, 10(3), 289–296. https://doi.org/10.1007/s12178-017-9426-3

3. Turner, M. N., Hernandez, D. O., Cade, W., Emerson, C. P., Reynolds, J. M., & Best, T. M. (2020). The Role of Resistance Training Dosing on Pain and Physical Function in Individuals With Knee Osteoarthritis: A Systematic Review. Sports health, 12(2), 200–206. https://doi.org/10.1177/1941738119887183

4. Fulton, J., Wright, K., Kelly, M., Zebrosky, B., Zanis, M., Drvol, C., & Butler, R. (2014). Injury risk is altered by previous injury: a systematic review of the literature and presentation of causative neuromuscular factors. International journal of sports physical therapy, 9(5), 583–595.

5. Myer, G. D., Ford, K. R., Barber Foss, K. D., Liu, C., Nick, T. G., & Hewett, T. E. (2009). The relationship of hamstrings and quadriceps strength to anterior cruciate ligament injury in female athletes. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 19(1), 3–8. https://doi.org/10.1097/JSM.0b013e318190bddb

6. Perspectives for patients. Knee pain: safely strengthening your thigh muscles. (2014). The Journal of orthopaedic and sports physical therapy, 44(5), 328. https://doi.org/10.2519/jospt.2014.0503

7. Espí-López, G. V., Arnal-Gómez, A., Balasch-Bernat, M., & Inglés, M. (2017). Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review. Journal of chiropractic medicine, 16(2), 139–146. https://doi.org/10.1016/j.jcm.2016.10.003

8. Pollard, H., Ward, G., Hoskins, W., & Hardy, K. (2008). The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of the Canadian Chiropractic Association, 52(4), 229–242.

9. Rutland, M., O'Connell, D., Brismée, J. M., Sizer, P., Apte, G., & O'Connell, J. (2010). Evidence-supported rehabilitation of patellar tendinopathy. North American journal of sports physical therapy : NAJSPT, 5(3), 166–178.

10. Eckenrode, B. J., Kietrys, D. M., & Parrott, J. S. (2018). Effectiveness of Manual Therapy for Pain and Self-reported Function in Individuals With Patellofemoral Pain: Systematic Review and Meta-analysis. The Journal of orthopaedic and sports physical therapy, 48(5), 358–371. https://doi.org/10.2519/jospt.2018.7243

11. Mayo Foundation for Medical Education and Research. (2021, May 11). Knee pain. Mayo Clinic. Retrieved September 13, 2021, from https://www.mayoclinic.org/diseases-conditions/knee-pain/symptoms-causes/syc-20350849.

12. Kim Y. J. Red flag rules for knee and lower leg differential diagnosis. Annals of translational medicine, 7(Suppl 7), 2019, S250.

13. Mordecai, S. C., Al-Hadithy, N., Ware, H. E., & Gupte, C. M. (2014). Treatment of meniscal tears: An evidence based approach. World journal of orthopedics, 5(3), 233–241. https://doi.org/10.5312/wjo.v5.i3.233